Why doulas are a mom’s best friend

By: Ann Douglas

Looking for a way to decrease the length of your labour, reduce your need for pain medication, decrease your chances of needing a forceps delivery or a Caesarean, and leave you feeling satisfied about your birth experience? What you need is a doula—the birthing world’s equivalent of a fairy godmother.

Think I’m exaggerating? Consider the evidence for yourself. There’s a growing body of research proving that doulas (experienced non-medical female companions who provide continuous labour support) can help to improve the birth and postpartum outcomes for both mother and baby. Klaus and Kennel found, for example, that when doulas are involved in labour and delivery, requests for epidurals decrease by 60 per cent, the Caesarean rate decreases by 50 per cent, oxytocin use during labour decreases by 40 per cent, requests for pain medications decrease by 30 per cent, and labours are 25 per cent shorter. And a study at the University of Texas Medical School found that women who used the services of a doula were more nurturing toward their babies two months after the delivery.

Doulas typically charge $300 to $1,200 for supporting a birth. This fee includes one or more meetings prior to the birth to talk with you and your partner about your plans, helping you to draft a birth plan, making herself available by phone to address any concerns the two of you may have about the birth, providing continuous support during labour, and providing support and breastfeeding help during the first few hours post-partum. Doulas do not, however, perform medical checks (such as monitoring your blood pressure or doing internal examinations), nor are they licensed to deliver babies. Their role is to provide labour support (most doctors are too busy to do this and some birthing unit nurses simply do not have the time) and, if necessary, to help you communicate your decisions to the medical staff.

The best way to get a referral to a doula who’s practising in your community is to contact your nearest midwifery practice. If there isn’t a midwifery practice in your community, you might want to contact Doulas of North America (DONA) via their website (www.dona.org ) or CAPPA Canada (1–866-CDN-BIRTH (236–2478) or www.cappacanada.ca ) to ask for the names of certified doulas in your area.

Facts and figures

Birthing doulas offer support during and after the birth, while postpartum doulas offer both hands-on assistance and motherly advice during the days and weeks following the birth. Some doulas offer both types of services to their clients.

The top 10 reasons to hire a doula

Here are 10 great reasons why you may want to think about inviting a doula to your baby’s birth.

1. A doula can help you to feel better about your birth experience. A group of researchers in California found that women who had the support of a doula during their babies’ births were more likely to feel positive about their birth experiences (82.5 per cent) than women who did not have the benefit of such support (67.4 per cent).

2. A doula can leave your partner free to focus more fully on his key role during the birth: providing you with emotional support. Doulas have knowledge of birth that partners, who may have no prior experience with birth, simply may not have.

3. A doula can help to take some of the pressure off your partner. Having someone else on hand to support you can allow him to take a guilt-free dinner or bathroom break. (It’s hard for your partner not to feel like the world’s biggest heel if he or she has to take a bathroom break just when your contractions are starting to peak.)

4. A doula can help to reduce the likelihood that you will require an epidural. A study conducted at Case Western Reserve University in Cleveland, Ohio, found that 7.8 per cent of women using doulas requested an epidural as compared to 55.3 per cent of women labouring without a doula.

5. A doula can offer helpful suggestions on ways to cope with the labour when you’ve pretty much run through your own repertoire of coping strategies.

6. A doula can help breastfeeding get off to the best possible start. A study conducted in South Africa found that women who have support from doulas during labour are more likely to be breastfeeding exclusively when their babies are six weeks old than other moms.

7. A doula can help to answer your questions about the birthing process and provide on-the-spot reassurance when you need it— something that can be truly invaluable if you find yourself with a lot of questions and concerns.

8. A doula can help you advocate for yourself with the hospital staff and ensure that your voice is heard.

9. A doula can promise to be there, even if your partner can’t. If there’s a chance that your partner isn’t going to be there at the birth (possibly because he or she is scheduled to work out of town around your due date) or if you’re going to be giving birth without a partner, a doula can provide you with some much-needed support.

10. A doula can act as your cheering section. When you’re trying to weather the storms of transition, sometimes you just need someone to tell you that you’ve got what it takes to get through this—and to say it with enough conviction that you actually believe her. (That’s an important part of the doula job description, by the way.)

Excerpted from The Mother of All Pregnancy Books, 2nd Edition. Copyright (c) 2011 by Ann Douglas. Excerpted with permission of the publisher John Wiley & Sons Canada, Ltd.